Evidence map›Paper›PMID 40931102›Full record

SynthesisSurgical endoscopy2025

Minimally invasive liver surgery for perihilar and intrahepatic cholangiocarcinoma: systematic review and meta-analysis of comparative studies.

Joey de Hondt, Maurice J W Zwart, Bas A Uijterwijk, George L Burchell, Burak Görgeç, Babs Zonderhuis, Geert Kazemier, Joris Erdmann, Marc G Besselink, Rutger-Jan Swijnenburg

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Joey de HondtDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Maurice J W ZwartDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Bas A UijterwijkDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
George L BurchellDepartment of Medical Informatics, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Burak GörgeçDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Babs ZonderhuisDepartment of Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Geert KazemierDepartment of Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Joris ErdmannDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Rutger-Jan SwijnenburgDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands. r.j.swijnenburg@amsterdamumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe implementation of minimally invasive liver surgery (MILS) for perihilar (PHC) and intrahepatic cholangiocarcinoma (IHC) remains limited and a systematic review including only comparative studies of MILS versus the open approach is lacking. This systematic review and meta-analysis aimed to assess the safety and efficacy of minimally invasive surgery in patients with hilar and intrahepatic cholangiocarcinomas.

methodsSystematic review in the PubMed, Embase, and Cochrane databases for original studies comparing at least five patients undergoing MILS with open liver surgery for PHC and IHC. Meta-analysis included the primary outcomes of morbidity and mortality. Secondary outcomes included post-operative outcomes, recurrence, disease-free survival, and resection margins.

resultsOverall, 37 comparative non-randomised studies with 4863 patients were included, of which 24% PHC and 76% IHC. In 21 studies, propensity score matching was performed. In total, 2106 laparoscopic, 75 robotic, and 2662 open procedures were analysed. The conversion rate was median 11.5% [IQR 10.0-12.5]. MILS probably resulted in reduced rates of major morbidity, 13.3% vs 18.8% (OR 0.75, 95%CI 0.62-0.90), mortality, 3.0% vs 4.5% (OR 0.69, 95%CI 0.49-0.97), and shorter hospital stay, 8.0 vs 10.9 days (MD -2.1, 95%CI -2.8 - -1.5). MILS resulted in higher rate of R0 resections in PSM cohort, 90.4% vs 81.4%, (OR 1.40, 95%CI 1.13-1.74) and better 3-year disease-free survival rate (49.9% vs 38.5%, HR

conclusionThis systematic review of non-randomised comparative studies suggests that MILS for PHC and IHC may result in a similar safety profile with benefits in patient recovery and oncological outcomes as compared to OLS. Prospective comparative studies, especially including robotic MILS, are warranted.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaHepatectomyKlatskin TumorLaparoscopyHumansPostoperative ComplicationsRobotic Surgical ProceduresTreatment OutcomeCholangiocarcinomaHepatectomyMinimally invasiveRobotic

Identifiers

PMID40931102
PMCPMC12618328

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.